悬雍垂腭咽成形术联合全缝线锚钉舌根悬吊术治疗阻塞性睡眠呼吸暂停的临床结局
Clinical Outcomes of Combined Uvulopalatopharyngoplasty and All-Suture Anchor Tongue Base Suspension for Obstructive Sleep Apnea.
文献信息
| PMID | 42942358 |
|---|---|
| 原文 | 在 PubMed 查看原文 ↗ |
| 发表日期 | 2026 |
| 作者 | Tzu-Ang Chen |
| 作者单位 | Department of Otolaryngology, Far Eastern Memorial Hospital, New Taipei City 220, Taiwan. |
| 期刊 | Medicina (Kaunas, Lithuania) |
| SCI 分区 | Q1 |
| IF | 3 |
| 研究类型 | 临床研究 · 临床 |
| 所属专科 | 咽喉科 |
中文摘要
背景与目的： 全缝线锚钉舌根悬吊术（TBS）是近期引入的一种方法，可在不使用永久性金属锚钉体的情况下实现下颌骨固定。将该技术纳入多平面手术时的临床结局数据仍有限。本研究评估了在成人中重度阻塞性睡眠呼吸暂停（OSA）患者中，采用全缝线锚钉TBS的多平面手术后的临床结局和术后并发症。
材料与方法： 这项回顾性单臂观察性研究纳入了40例连续成人中重度OSA患者中的30例，这些患者经多导睡眠监测确诊，无法耐受或拒绝持续气道正压通气治疗，并且具有完整的术后多导睡眠监测及至少6个月的随访。所有患者均接受悬雍垂腭咽成形术联合全缝线锚钉TBS。术前和术后6个月的评估包括呼吸暂停低通气指数（AHI）、最低血氧饱和度、Epworth嗜睡量表（ESS）、打鼾视觉模拟量表（VAS）和体重指数（BMI）。
结果： 中位AHI从50.5（Q1-Q3，38.0-68.0）次/小时降至15.7（Q1-Q3，11.1-21.4）次/小时（p < 0.001）。ESS从16.3 ± 2.5改善至7.5 ± 2.4（p < 0.01），最低血氧饱和度从68.5% ± 6.5%升高至82.8% ± 9.2%（p < 0.01）。22例患者（73%）达到手术成功。并发症主要为轻度和一过性；未发生感染、缝线断裂或永久性功能缺陷。
结论： 采用全缝线锚钉TBS的多平面手术与6个月时客观和主观睡眠结局的显著改善相关，并发症主要为轻度和一过性。这些发现支持将该技术纳入多平面手术方案的可行性；仍需比较性研究以确定TBS的具体贡献。
英文摘要
Background and Objectives: All-suture anchor tongue base suspension (TBS) is a recently introduced approach that provides mandibular fixation without a permanent metallic anchor body. Clinical outcome data for this technique when incorporated into multilevel surgery remain limited. This study evaluated clinical outcomes and postoperative complications following multilevel surgery incorporating all-suture anchor TBS in adults with moderate-to-severe obstructive sleep apnea (OSA). Materials and Methods: This retrospective single-arm observational study included 30 of 40 consecutive adults with polysomnography-confirmed moderate-to-severe OSA who were intolerant of or declined continuous positive airway pressure therapy and had complete postoperative polysomnography and at least 6 months of follow-up. All patients underwent uvulopalatopharyngoplasty combined with all-suture anchor TBS. Preoperative and 6-month postoperative assessments included the apnea-hypopnea index (AHI), nadir oxygen saturation, Epworth Sleepiness Scale (ESS), snoring visual analog scale (VAS), and body mass index (BMI). Results: Median AHI decreased from 50.5 (Q1-Q3, 38.0-68.0) to 15.7 (Q1-Q3, 11.1-21.4) events/h (p < 0.001). ESS improved from 16.3 ± 2.5 to 7.5 ± 2.4 (p < 0.01), and nadir oxygen saturation increased from 68.5% ± 6.5% to 82.8% ± 9.2% (p < 0.01). Surgical success was achieved in 22 patients (73%). Complications were predominantly mild and transient; no infection, suture rupture, or permanent functional deficit occurred. Conclusions: Multilevel surgery incorporating all-suture anchor TBS was associated with significant improvements in objective and subjective sleep outcomes at 6 months, with predominantly mild and transient complications. These findings support the feasibility of incorporating this technique into a multilevel surgical protocol; comparative studies are needed to determine the specific contribution of TBS.